| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL DONLEY3 | 2241 PUEBLO COURT SIOUX CITY, IA 51104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $30K | $984 | $31K | 15.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 718 SIOUX CITY, IA 51102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $679 | $13K | 6.38% |
| ROBERT E ELLIS3 Filed as: ROBERT E. ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $2K | $6K | 3.07% |
| GARY L HOLTROP3 Filed as: GARY L. HOLTROP | PO BOX 36 IRETON, IA 51027 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $279 | — | $279 | 0.14% |
| DUANE A ADAMS3 Filed as: DUANE L. GOTTSCH | 2220 NORTH 172ND AVENUE OMAHA, NE 68116 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $140 | — | $140 | 0.07% |
| MJ INSURANCE3 Filed as: SCOTT S. AND VARIOUS AGENTS | 5701 KENTUCKY AVENUE NORTH CRYSTAL, MN 55428 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $49 | — | $49 | 0.02% |
| RICHARD RILEY3 | 76 WEST BRAHMAN BOULEVARD SAN TAN VALLEY, AZ 85143 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.02% |
| UNICO MIDLANDS LLC3 Filed as: UNICO MIDLANDS, LLC | 7101 SOUTH 82ND STREET LINCOLN, NE 68516 | AMERITAS LIFE INSURANCE CORPORATION | $3K | — | $3K | 2.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4280 SERGEANT ROAD, SUITE 200 SIOUX CITY, IA 51106 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $1K | $6K | 11.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4280 SERGEANT ROAD, SUITE 200 SIOUX CITY, IA 51106 | VISION SERVICE PLAN | $1K | — | $1K | 3.98% |
| UNICO MIDLANDS LLC3 Filed as: UNICO MIDLANDS, LLC | 7101 SOUTH 82ND STREET LINCOLN, NE 68516 | VISION SERVICE PLAN | $253 | — | $253 | 0.90% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 227 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 675 | $124K |
| Vision | VISION SERVICE PLAN | 293 | $28K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 273 | $49K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 153 | $198K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 273 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 675 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.